Application Of Accurate Quantitative SPECT/CT In Diagnosis And Evaluation Of Breast Cancer Bone Metastases

Objective1. To analyze the diagnostic efficacy of conventional SPECT/CT and quantitative SPECT/CT imaging,and to explore the advantages of quantitative SPECT/CT in the diagnosis of bone metastasis of breast cancer.2.Quantitative SPECT/CT examination was performed before and after treatment,the value of quantitative SPECT/CT in evaluating the effect of bone metastases was compared by comparing the changes in SUVmax of bone metastases of breast cancer before and after treatment.Methods1.A total of 63 patients with suspected bone metastases of breast cancer were examined by conventional SPECT/CT and quantitative SPECT/CT from December 2017 to May2019.single or multiple radioactive abnormalities were found in whole body bone imaging.SPECT/CT fusion imaging was performed on the suspected bone metastases.Among them,30 patients used conventional SPECT/CT imaging and 33 patients used quantitative SPECT/CT imaging.A preliminary diagnosis of suspicious lesions by the nuclear medicine physician,follow up the initial diagnosis,regularly review the CT,MRI or pathological puncture results to get the final correct diagnosis,initial diagnosis results were compared with the final diagnosis results,and the sensitivity,specificity,and accuracy of conventional SPECT/CT imaging and quantitative SPECT/CT imaging for diagnosis of bone metastases were calculated.Using SPSS 16.0 software,the differences between the two sets of conventional SPECT/CT imaging and quantitative SPECT/CT imaging were analyzed byχ~2 test.2.33 patients with bone metastasis of breast cancer diagnosed by pathology or imaging were collected.All the selected patients underwent quantitative SPECT/CT imaging before and after treatment,and the SUVmax value before treatment of bone metastases was measured,bone metastases were treated continuously for two months,including chemotherapy,radiotherapy,endocrine therapy,targeted therapy,and bisphosphonates.After one months of treatment,quantitative SPECT/CT imaging was performed again,and collected the SUVmax value after the same bone metastasis treatment.SPSS 16.0statistical software was used to compare the SUVmax values before and after treatment of bone metastases with paired t test.Results1. Routine SPECT/CT imaging was performed in 30 cases.Twenty cases were initially diagnosed with bone metastases(8 cases with single bone metastases,12 cases with multiple bone metastases),and 10 with non-bone metastases,the final diagnosis was 24cases of bone metastases(8 cases of single bone metastases,16 cases of multiple bone metastases),and 6 with non-bone metastases,sensitivity,specificity,and accuracy are75.00%,66.70%,and 73.30%,respectively.Quantitative SPECT/CT imaging in total 33cases,29 cases of bone metastases were initially diagnosed(13 cases of single bone metastases,16 cases of multiple bone metastases),and 4 with non-bone metastases.The final diagnosis was 29 cases of bone metastases(11 cases of single bone metastases,18cases of multiple bone metastases),and 4 with non-bone metastases.The sensitivity,specificity,and accuracy are96.60%,75.00%,and 93.90%,respectively.The difference is statistically significant(χ~2=4.09,P=0.043).2. Quantitative SPECT/CT imaging was performed before and after treatment in 33patients diagnosed with bone metastases from breast cancer.The minimum SUVmax of the bone metastases before treatment was 11.07,the maximum was 46.08,and the average SUVmax was 22.60,the minimum,maximum,and average SUVmax of bone metastases after treatment were 5.60,61.82,and 16.71.The difference was statistically significant(t=3.01,P<0.05).ConclusionQuantitative SPECT/CT can significantly improve the diagnostic efficacy of breast cancer bone metastases,and has important value in the evaluation of breast cancer bone metastasis treatment efficacy.